An effective protocol for heart transplantation during COVID‐19 outbreak

Since SARS-CoV-2 outbreak and worldwide diffusion, transplant centers have been challenged with novel issues such as the opportunity to maintain transplant programs during the pandemic phase. General recommendations have been provided by scientific societies however, specific protocols are required to limit virus diffusion during the various phases of transplant procedure. Since the beginning of COVID-19 outbreak we have adopted a dedicated protocol to "protect" our newly heart transplanted patients during the pandemic. The protocol focused on a careful exclusion of SARS-CoV-2 infection of both donors and recipients and on evaluation of the risk-to-benefit ratio between the urgent needs of the recipient and its COVID-19-related risk. Since we adopted the described strategy, we have performed eleven heart transplants. No patient had in-hospital SARS-CoV-2 infection. Only one patient died on waiting list. Our initial experience supports the maintenance of transplant programs even during the epidemic phase of the infection.